title: Survival and quality of life in an elderly cardiac surgery population: 5-year follow-up.
abstract: OBJECTIVE
  As survival after cardiac surgery has become very satisfactory even in elderly patients, more attention is being directed towards improved health-related quality of life (HRQOL). However, longitudinal prospective cohort studies describing HRQOL after cardiac surgery are still scarce. The purpose of this study was to explore HRQOL and survival in patients undergoing cardiac surgery after 5 years, emphasizing on older patients (≥75 years).
  
  
  METHODS
  In a prospective population-based study, 534 patients (23% ≥75 years, 67% males) were consecutively included before surgery. HRQOL and medical and sociodemographic variables were measured by questionnaires at baseline, 6 and 12 months after surgery and again after 5 years. HRQOL was measured by the Short-Form 36 Health Survey (SF-36).
  
  
  RESULTS
  Four hundred and fifty-eight patients were alive after 5 years, with a response rate of 82%. Older patients had lower 5-year survival than younger patients (P = 0.042), but it was similar to that of the general population. After 5 years, both older and younger patients had slightly lower scores on some SF-36 dimensions, compared with scores after 6 and 12 months. However, on seven of eight subscales of the SF-36, the scores after 5 years were still higher than before surgery. Older patients improved less from baseline to the follow-up, and had more profound reductions in scores from 12 months to 5 years on three subscales; physical functioning (P = 0.013), role physical (P < 0.001) and vitality (P = 0.036).
  
  
  CONCLUSIONS
  HRQOL improved from baseline to 6 months postoperatively, and remained relatively stable 5 years after cardiac surgery even in elderly patients. The study showed that survival and HRQOL can match that of the general population.
authors.affiliation: Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. kari.hanne.gjeilo@stolav.no
authors.forename: Kari Hanne
authors.initials: KH
authors.lastname: Gjeilo
authors.forename: Alexander
authors.initials: A
authors.lastname: Wahba
authors.forename: Pål
authors.initials: P
authors.lastname: Klepstad
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.forename: Roar
authors.initials: R
authors.lastname: Stenseth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Aged; Cardiac surgical procedures; Health surveys; Quality of life; Survival